Individual
MRS. JAN SHARPLESS GOODHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6161 S YALE AVE, TULSA, OK 74136-1902
(918) 494-1471
Mailing address
24355 S LINDLEY DR, CLAREMORE, OK 74019-0281
(918) 341-4407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TA490
OK
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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